From June to September 2025, we recruited adult (age ≥18 years) Black breast cancer survivors residing in Baltimore, Maryland, and 3 surrounding counties. Individuals who were not born female, did not speak English, were diagnosed at stage 0, and were in active cancer treatment or completed active treatment <2 years ago were ineligible. Figure 1 summarizes study procedures. Potentially eligible patients (based on electronic health records) who were seen at any of 4 Johns Hopkins Medicine hospitals or clinics within the past 5 years received a recruitment message in their MyChart (Epic Systems Corp) patient portal. Those who did not have an active MyChart account were emailed the recruitment message. We partnered with community-based organizations to disseminate a study flyer via email and to conduct a webinar. Recruitment source was self-reported in the study’s survey.

The 20‐ to 30-minute online survey was deployed via REDCap (Vanderbilt University). To enhance internal validity, we aimed to collect biospecimens within 2 weeks of each participant’s survey completion. Respondents were asked to indicate their availability for a blood draw appointment and need for study-arranged transportation assistance via Lyft. Blood draws were completed at the Johns Hopkins ProHealth Clinical Research Unit, where ProHealth staff collected small-volume blood samples (4 mL) and measured participants’ height and weight. Respondents were also asked whether they were interested in participating in one of four 75-minute virtual focus groups via Zoom. Completing the survey was a prerequisite for being scheduled for a blood draw, and completing the blood draw was a prerequisite for being invited to a focus group.

We evaluated feasibility across 3 feasibility framework-guided domains: recruitment, sociodemographic representativeness, and assessment procedures [6,7]. Findings are reported using frequencies and percentages. (Focus group findings are not reported in this paper.) Analyses were performed using SAS (version 9.4; SAS Institute Inc).

The study received ethics approval from the Institutional Review Board of the Johns Hopkins Bloomberg School of Public Health (IRB00031122). Electronic informed consent was obtained from all participants prior to data collection. Study data were deidentified. Each participant received a US $75 Tango gift card after survey completion and biospecimen donation and a US $50 Tango gift card after focus group participation.

This study provides evidence on the feasibility of recruiting and engaging a heterogeneous sample of Black breast cancer survivors in SDOH research using online approaches. Online recruitment was feasible, particularly via patient portal. Recruiting a sociodemographically diverse sample and administering assessments also were feasible.

Most participants were recruited from the patient portal, which likely reached a larger number of individuals than other channels. Also, individuals reached through the patient portal may have had greater interest in research participation than email recipients (who were, by definition, nonportal users) or other individuals, potentially due to higher health care system engagement or trust. Overall, study findings align with previous research on the use of digital channels for engaging diverse populations in research. Evidence indicates that digital recruitment approaches, including online recruitment and recruitment using electronic medical records, can enhance representation in health research [8]. Additionally, online strategies to recruit underrepresented groups may benefit from health care provider and/or community partner endorsements [8]. Our future research will seek to enhance community partner–based recruitment.

Despite the availability of transportation assistance, 3 participants did not complete a blood draw; they did not respond to appointment scheduling attempts. Our subsequent research may incorporate approaches such as mobile phlebotomy or self-collection, which may be more convenient and acceptable [9,10]. Additionally, despite high interest, scheduling difficulties (eg, participant work schedules, competing demands) precluded virtual focus group participation among several participants. Our future research may offer additional focus groups or employ one-on-one interviews to facilitate greater scheduling flexibility.

Potential study limitations include the modest sample size, recruitment from a single state, and the sample comprising Black breast cancer survivors only. Therefore, findings may have limited generalizability. Also, the study’s online approach may have disproportionately reached survivors with greater digital access and/or health care system engagement.

Findings from this feasibility study inform the development of the next phase of our mixed methods research on SDOH and cancer disparities. Results demonstrate the utility of recruiting and engaging sociodemographically diverse research participants using a variety of online methods.